Zamorano José Luis, Álvarez-Bartolomé Mercedes, Arzamendi Dabit, Carnero-Alcázar Manuel, Cruz-González Ignacio, Li Chi-Hion Pedro, Pardo-Sanz Ana, Martínez-Pérez Óscar, Cerezales Mónica, Cuervo Jesús, Vernia Matteo, González Paloma, Martí-Sánchez Belén
Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.
Cardiology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain.
J Clin Med. 2024 Oct 24;13(21):6372. doi: 10.3390/jcm13216372.
: Mitral regurgitation (MR) is the second most common valve disease in Europe, and differences between men and women have been described in relation to aetiology or management, which might impact the decision for intervention and patients' clinical and economic outcomes. Thus, the objective was to analyse the burden of MR in Spain by aetiology and sex, and the management of all patients suffering from MR being admitted to hospital between 2016-2021. : An analysis was carried out with the Ministry of Health's database, including all patients in public and subsidised hospitals and defining two groups, general MR and those patients undergoing Transcatheter Edge-to-Edge repair (TEER), using a descriptive analysis of patients' characteristics, use of resources, and outcomes; standardised rates were calculated and observed outcomes were described. : Hospital admissions increased from 2016 ( = 32,806) to 2021 (total = 61,036). In general, the women were older and presented more complications. The majority of patients suffered from degenerative MR (DMR) ( = 183,005, 59.55%), and 61.56% were women, contrary to functional MR (FMR) ( = 124,278), which consisted of 62.15% males. In total, 1,689 TEERs were performed, 23.33% of them in urgent admissions, and mostly in men (65.66%). All groups showed higher rates of intervention for males. Regarding costs, women presented lower mean costs in the general MR groups but those undergoing TEER presented, in all cases, costs higher than men. : MR entails a significant burden for patients and the Spanish healthcare system, increasing over the period of study. Differences in aetiologies by sex have been found in patients' characteristics as well as outcomes. Further studies are needed to optimise patients' management and their outcomes in relation to sex and aetiology.
二尖瓣反流(MR)是欧洲第二常见的瓣膜疾病,在病因或治疗方面男女存在差异,这可能会影响干预决策以及患者的临床和经济结局。因此,本研究旨在按病因和性别分析西班牙MR的负担,以及2016年至2021年期间所有因MR入院患者的治疗情况。
对卫生部数据库进行了分析,纳入了公立和补贴医院的所有患者,并分为两组,即一般MR患者和接受经导管缘对缘修复(TEER)的患者,对患者特征、资源使用情况和结局进行描述性分析;计算标准化率并描述观察到的结局。
医院入院人数从2016年的32806例增加到2021年的61036例。总体而言,女性年龄更大,并发症更多。大多数患者患有退行性MR(DMR)(183005例,59.55%),其中61.56%为女性,而功能性MR(FMR)(124278例)则相反,男性占62.15%。共进行了1689例TEER手术,其中23.33%为急诊入院,且大多数为男性(65.66%)。所有组男性的干预率均更高。在费用方面,一般MR组中女性的平均费用较低,但接受TEER手术的女性在所有情况下费用均高于男性。
MR给患者和西班牙医疗系统带来了巨大负担,且在研究期间有所增加。在患者特征和结局方面发现了按性别划分的病因差异。需要进一步研究以优化与性别和病因相关的患者管理及其结局。